Gastrointestinal Tract Diseases Overview
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Questions and Answers

What is the primary cause of aphthous ulcers?

  • Fungal infection
  • Bacterial infection
  • Unknown etiology (correct)
  • Viral infection

    • Which of the following is a potential complication of oral candidiasis?

  • Development of leukoplakia
  • Invasive disease in immunosuppressed individuals (correct)
  • It leads to permanent scarring
  • Formation of cold sores

    • What percentage of oral leukoplakia cases are estimated to transform into squamous cell carcinoma?

  • 30-40%
  • 5-15% (correct)
  • 20-25%
  • 50-60%

    • Which site is NOT commonly affected by squamous cell carcinoma related to oral leukoplakia?

    <p>Back of the throat</p> Signup and view all the answers

    What is the most prevalent tissue type in pleomorphic adenoma?

    <p>A heterogeneous mixture of epithelial and mesenchymal cells</p> Signup and view all the answers

    Which condition is associated with the risk of developing sialadenitis?

    <p>Trauma to the salivary glands</p> Signup and view all the answers

    Mucoepidermoid carcinoma is primarily characterized by which type of cell composition?

    <p>A mixture of squamous and mucous cells</p> Signup and view all the answers

    What is the common demographic for benign pleomorphic adenoma tumors?

    <p>Individuals in their 6th and 7th decades of life</p> Signup and view all the answers

    Which factor contributes to increased blood pressure through the renin-angiotensin system?

    <p>Increase in peripheral resistance</p> Signup and view all the answers

    What is a common immunologic basis for non-infectious vasculitis?

    <p>Immune complex deposition</p> Signup and view all the answers

    Which type of vasculitis primarily affects the medium-sized arteries and may involve renal arteries?

    <p>Polyarteritis nodosa</p> Signup and view all the answers

    Which congenital cardiac defect has the highest percentage of malformations?

    <p>Ventricular septal defect</p> Signup and view all the answers

    What is the expected outcome when coronary artery obstruction reaches 90%?

    <p>Symptoms at rest (angina pectoris)</p> Signup and view all the answers

    Which of the following tumors is typically benign and characterized by vascular channels lined by normal endothelial cells?

    <p>Hemangioma</p> Signup and view all the answers

    Which condition is characterized by acute necrotizing granulomas mainly affecting the lungs and kidneys?

    <p>Wegner's granulomatosis</p> Signup and view all the answers

    What is the primary pathological mechanism behind ischemic heart disease (IHD)?

    <p>Diminished coronary perfusion</p> Signup and view all the answers

    Which of the following is a significant clinical feature of vasculitis?

    <p>Vascular wall inflammation</p> Signup and view all the answers

    Which of the following statements about vascular tumors is correct?

    <p>Malignant tumors can exhibit cytologic atypia</p> Signup and view all the answers

    What characterizes a sliding hiatal hernia?

    <p>Accounts for 95% of all hiatal hernias.</p> Signup and view all the answers

    Which statement is true regarding achalasia?

    <p>It leads to hypertonicity of the lower esophageal sphincter.</p> Signup and view all the answers

    What is the primary risk factor for Barrett's Esophagus?

    <p>Long-standing gastroesophageal reflux.</p> Signup and view all the answers

    Which of the following conditions is most closely associated with squamous cell carcinoma of the esophagus?

    <p>Long-standing esophagitis.</p> Signup and view all the answers

    Chronic gastritis primarily caused by H. pylori typically leads to which consequence?

    <p>Atrophy of the gastric mucosa.</p> Signup and view all the answers

    What is a significant consequence of autoimmune gastritis?

    <p>Pernicious anemia due to lack of B12 absorption.</p> Signup and view all the answers

    Which factor contributes to the virulence of H. pylori?

    <p>Production of urease.</p> Signup and view all the answers

    What does peptic ulceration primarily disrupt?

    <p>Mucosal defense mechanisms.</p> Signup and view all the answers

    What is a common microscopic feature of esophagitis?

    <p>Presence of eosinophils.</p> Signup and view all the answers

    Which type of gastric cancer is generally positioned in the lower esophagus?

    <p>Adenocarcinoma.</p> Signup and view all the answers

    What initiates the inflammatory process in acute gastritis?

    <p>Heavy NSAID use.</p> Signup and view all the answers

    The typical M:F ratio for esophageal carcinoma is?

    <p>3:1.</p> Signup and view all the answers

    What condition is a classic example of secondary achalasia?

    <p>Chagas disease.</p> Signup and view all the answers

    What is the primary histological feature of chronic gastritis associated with duodenal ulcers?

    <p>Active non-specific inflammatory cell infiltration</p> Signup and view all the answers

    Which type of gastric carcinoma is primarily associated with dietary risk factors such as excess salt intake?

    <p>Intestinal carcinoma</p> Signup and view all the answers

    What are Curling’s ulcers primarily associated with?

    <p>Severe burns</p> Signup and view all the answers

    Which statement about Meckel’s diverticulum is correct?

    <p>It results from the failure of duct involution.</p> Signup and view all the answers

    Which of the following is NOT a cause of ischemic bowel disease?

    <p>Iron deficiency</p> Signup and view all the answers

    Which type of diarrhea is primarily related to increased osmotic load?

    <p>Osmotic diarrhea</p> Signup and view all the answers

    Which form of inflammatory bowel disease can affect any part of the gastrointestinal tract?

    <p>Crohn’s disease</p> Signup and view all the answers

    What is a significant histological characteristic of celiac disease?

    <p>Flattening of mucosal villi</p> Signup and view all the answers

    What is the most common complication of Hirschsprung’s disease?

    <p>Megacolon</p> Signup and view all the answers

    Which factor is NOT linked to the development of intestinal type gastric carcinoma?

    <p>High carbohydrate diet</p> Signup and view all the answers

    The presence of which cell type is most indicative of acute inflammatory response in ulcers?

    <p>Neutrophils</p> Signup and view all the answers

    What is the male to female ratio commonly observed in Hirschsprung’s disease?

    <p>4:1</p> Signup and view all the answers

    In which part of the gastrointestinal tract does H. pylori primarily cause ulcers?

    <p>Duodenum</p> Signup and view all the answers

    Which condition is characterized by an absence of myenteric and submucosal plexuses?

    <p>Hirschsprung’s disease</p> Signup and view all the answers

    What is the hallmark gross characteristic of the bowel affected by systemic amyloidosis?

    <p>Rubbery and thickened wall with narrowed lumen</p> Signup and view all the answers

    In Ulcerative Colitis, what is the primary type of inflammatory infiltrate observed microscopically?

    <p>Mononuclear inflammatory cell infiltration</p> Signup and view all the answers

    What percentage of colorectal carcinomas develop in patients with Familial Polyposis Syndrome if left untreated?

    <p>100%</p> Signup and view all the answers

    Which factor is associated with the increased risk of colorectal carcinoma in Ulcerative Colitis after 20 years?

    <p>Left colonic involvement</p> Signup and view all the answers

    In systemic amyloidosis, which histological alteration is noted in the mucosa?

    <p>Dysplastic changes with risk of carcinoma</p> Signup and view all the answers

    What are carcinoid tumors primarily derived from?

    <p>Neuroendocrine cells</p> Signup and view all the answers

    Which of the following is a potential complication of chronic inflammation in Ulcerative Colitis?

    <p>Colonic carcinoma development</p> Signup and view all the answers

    What is the typical location for colorectal carcinomas?

    <p>Cecum and ascending colon</p> Signup and view all the answers

    What type of dietary factors is linked to colorectal cancer risk?

    <p>Low fiber and high refined carbohydrates</p> Signup and view all the answers

    Which component of endothelial cell function is critical for the maintenance of vascular integrity?

    <p>Elaboration of anticoagulant molecules</p> Signup and view all the answers

    What is a characteristic of inflammatory responses involving endothelial cells?

    <p>Increased leukocyte adhesion</p> Signup and view all the answers

    Which of the following changes is NOT typically seen in fibrotic tissue development?

    <p>Decrease in vascular permeability</p> Signup and view all the answers

    Which factor contributes to the aggressiveness of carcinoid tumors?

    <p>All of the above</p> Signup and view all the answers

    What is one of the key differences between systemic amyloidosis and Ulcerative Colitis?

    <p>Type of bowel damage</p> Signup and view all the answers

    Which of the following describes a characteristic of unstable atherosclerotic plaques?

    <p>Large lipid cores with dense inflammatory infiltrates</p> Signup and view all the answers

    What is the primary component of atherosclerotic plaques that contributes to narrowing of the vascular lumen?

    <p>Lipid accumulation</p> Signup and view all the answers

    Which of the following represents a non-modifiable risk factor for ischemic heart disease?

    <p>Family history</p> Signup and view all the answers

    Which lesion type is characterized by lipid-laden smooth muscle cells?

    <p>Type II lesion</p> Signup and view all the answers

    What is the main physiological cause of essential hypertension?

    <p>Complex and multifactorial</p> Signup and view all the answers

    Which of these is NOT considered a complication of atherosclerosis?

    <p>Fatty streaks</p> Signup and view all the answers

    Which of the following is a potential consequence of chronic endothelial cell injury in atherosclerosis?

    <p>Enhanced platelet adhesion</p> Signup and view all the answers

    Which risk factor is classified as a minor contributor to ischemic heart disease?

    <p>Obesity</p> Signup and view all the answers

    What is the definition of hypertension based on diastolic pressure?

    <p>Greater than 90 mm Hg</p> Signup and view all the answers

    Which type of plaque is more likely to lead to acute ischemic complications?

    <p>Unstable plaques</p> Signup and view all the answers

    Which of the following factors primarily initiates the pathogenesis of atherosclerosis?

    <p>Chronic oxidative stress</p> Signup and view all the answers

    How does the presence of foam cells relate to atherosclerosis?

    <p>They contribute to the fatty streak formation.</p> Signup and view all the answers

    Which condition is most likely to secondary hypertension?

    <p>Chronic renal disease</p> Signup and view all the answers

    What is a common physiological outcome of hypertension?

    <p>Cardiac hypertrophy</p> Signup and view all the answers

    What is the prevalent myocardial change observed in the early hours following an irreversible injury from myocardial infarction?

    <p>None; variable waviness of fibers</p> Signup and view all the answers

    Which morphological feature is characteristic of coagulation necrosis associated with myocardial infarction after 1-3 days?

    <p>Loss of nuclei</p> Signup and view all the answers

    What is a common consequence of myocardial infarction?

    <p>Decreased contractility</p> Signup and view all the answers

    Acute infective endocarditis typically leads to which of the following outcomes?

    <p>Destruction of normal heart valves</p> Signup and view all the answers

    In chronic rheumatic heart disease, which structural change is typically observed in the mitral valve?

    <p>Commissural fusion and shortening</p> Signup and view all the answers

    Which organism is commonly associated with subacute endocarditis in patients with abnormal heart valves?

    <p>Streptococcus viridans</p> Signup and view all the answers

    In the context of acute rheumatic fever, which symptom is considered a major manifestation?

    <p>Migratory polyarthritis</p> Signup and view all the answers

    What aspect of myocardial inflammation does the term 'pancarditis' specifically refer to?

    <p>Involvement of all three heart layers</p> Signup and view all the answers

    Which phase following myocardial infarction is characterized by increased collagen deposition and decreased cellularity?

    <p>2-8 weeks</p> Signup and view all the answers

    Which of the following is a predisposing factor for infective endocarditis?

    <p>Valvular deformity</p> Signup and view all the answers

    What is the typical time frame for the development of necrotizing, ulcerative infections in acute endocarditis caused by highly virulent microbes?

    <p>Days</p> Signup and view all the answers

    Which process in myocardial infarction involves the infiltration of neutrophils?

    <p>Coagulation necrosis</p> Signup and view all the answers

    What characterizes the lesions known as Aschoff bodies observed in acute rheumatic fever?

    <p>Foci of collagen surrounded by lymphocytes</p> Signup and view all the answers

    What is a primary complication associated with aneurysms?

    <p>Rupture</p> Signup and view all the answers

    Which factor does NOT contribute to the development of varicose veins?

    <p>Increased dietary fiber</p> Signup and view all the answers

    What is the threshold venous pressure that allows blood from superficial veins to enter deep veins during muscle relaxation?

    <p>30 mmHg</p> Signup and view all the answers

    Heart failure can result from abnormalities in which of the following functions?

    <p>Systolic or diastolic function</p> Signup and view all the answers

    What is a key etiology of deep vein incompetency?

    <p>Retrograde flow in deep veins</p> Signup and view all the answers

    Which type of aneurysm occurs in the brain and is often referred to as a 'berry aneurysm'?

    <p>Cerebral aneurysm</p> Signup and view all the answers

    Which method is advised for diagnosing post-thrombotic disease?

    <p>Venography</p> Signup and view all the answers

    What is a potential outcome when pulmonary capillary pressure exceeds the oncotic pressure of plasma proteins?

    <p>Interstitial edema</p> Signup and view all the answers

    Which of these is not a compensatory mechanism of heart failure?

    <p>Decreased heart rate</p> Signup and view all the answers

    What contributes to the pathological alterations in the extracellular matrix in heart failure?

    <p>Changes in collagen turnover</p> Signup and view all the answers

    Which genetic factor is associated with familial predisposition to varicose veins?

    <p>FOX C2 gene</p> Signup and view all the answers

    Which of these is a symptom commonly associated with varicose veins?

    <p>Leg ulcer</p> Signup and view all the answers

    What primarily indicates the presence of thrombosis in veins?

    <p>Retrograde blood flow</p> Signup and view all the answers

    Which of these conditions is least likely to lead to heart failure?

    <p>Hypotension</p> Signup and view all the answers

    Study Notes

    Gastrointestinal Tract (GIT) Diseases

    • Oral Cavity:

      • Aphthous ulcers: Painful, superficial ulcers of unknown cause; may be associated with systemic diseases.
      • Herpes simplex virus (HSV): Causes a self-limited infection with vesicles (cold sores); latent virus in nerve ganglia can reactivate.
      • Oral candidiasis: Occurs when the oral microbiota is altered, e.g., after antibiotic use; immunosuppressed individuals at risk for invasive disease.
      • Fibromas and pyogenic granulomas: Common reactive lesions of the oral mucosa.
      • Leukoplakia: White, well-defined mucosal patch/plaque; caused by epithelial thickening/hyperkeratosis; common in older individuals (lower lip, buccal mucosa, hard/soft palate); can progress to carcinoma in situ; Risk factors include tobacco, chronic friction, alcohol, irritants, HPV.
      • Oral cancers: Mostly squamous cell carcinomas; Risk factors include leukoplakia, erythroplasia, tobacco, alcohol, HPV types 16, 18, and 11, chronic irritation, Plummer-Vinson syndrome; Common sites include lateral margins of lower lip, floor of mouth, lateral borders of tongue.

    • Salivary Gland Diseases:

      • Sialadenitis: Inflammation of salivary glands, caused by trauma, infection (e.g., mumps), or autoimmune reaction.
      • Pleomorphic adenoma: Slow-growing benign neoplasm; heterogeneous mixture of epithelial/mesenchymal cells.
      • Mucoepidermoid carcinoma: Malignant neoplasm of variable aggressiveness; mixture of squamous/mucous cells.
      • Salivary gland tumors: 80% in parotid glands; equal male/female ratio; (6th/7th decades of life); 70-80% of parotid tumors are benign; Pleomorphic adenomas are slow-growing, well-demarcated, encapsulated tumors; rarely exceed 6 cm in diameter; Histologically: epithelial elements from ducts, acini, tubules, strands or sheets of cells; loose myxoid connective tissue stroma; chondroid or bone.

    • Diseases of the Esophagus:

      • Hiatal hernia: Two types: Sliding hernia (95%) and rolling (paraeosophageal) hernia; common presentation is reflux esophagitis.
      • Achalasia: Incomplete relaxation of lower esophageal sphincter (LES) upon swallowing; obstruction of lower esophagus, dilatation of proximal part; Classic secondary example is Chagas disease (T. cruzi); risk for squamous cell carcinoma in 5% of cases.
      • Barrett's esophagus: Complication of long-standing esophageal reflux (11% of symptomatic patients); replacement of normal distal squamous epithelium by abnormal metaplastic columnar epithelium containing goblet cells. High risk of adenocarcinoma (30-40x).
      • Esophagitis: Causes include prolonged gastric intubation, uremia, ingestion of corrosives/irritants, radiation, chemotherapy, and reflux. Microscopically: Eosinophils/neutrophils; basal zone hyperplasia; lamina propria papillae elongation. Complications include bleeding, strictures, Barrett's metaplasia leading to cancer.
      • Esophageal carcinoma: Mostly squamous cell carcinoma or adenocarcinoma; male/female ratio of 3:1; Risk factors include long-standing esophagitis, achalasia, Plummer-Vinson syndrome, alcohol/tobacco, vitamin/trace mineral deficiencies, nitrosamines. Squamous cell carcinomas arise from squamous dysplasia or carcinoma in situ as small grey-white plaque-like thickenings. Tumour types: Polypoid fungating masses, necrotizing ulcerations, diffuse infiltration; (20% cervical/upper thoracic, 50% middle third, 30% lower third). Adenocarcinoma (25% of esophageal cancers), usually in the lower esophagus.

    • Diseases of the Stomach:

      • Chronic gastritis: Mucosal inflammatory changes leading to mucosal atrophy and epithelial metaplasia. Pathogenesis: H. pylori (most important pathogen); autoimmune (autoantibodies against gastric parietal cells); unknown causes (mostly Japan). H. pylori infection → antral gastritis. Over time can lead to pangastritis and risk for multifocal atrophic gastritis. Autoimmune type is often seen with other autoimmune disorders.
      • Acute gastritis: Acute inflammation (transient), accompanied by hemorrhage and sloughing of superficial mucosa (erosion); Heavy NSAID use, alcohol, smoking, chemo, uremia, systemic infection (e.g., typhoid), severe stress (trauma, burns, surgery), ischemia/shock, ingestion of acids/alkalis, mechanical trauma (N.G. tube), bile reflux after partial gastrectomy. Pathophysiology: Disruption of mucosa, acid secretion stimulation, decreased bicarbonate production, reduced mucosal blood flow, direct damage of epithelium. Microscopically: Superficial to complete mucosal involvement; mucosal edema, neutrophilic infiltrate, chronic inflammatory infiltrate, and regenerative replication.
      • Peptic ulceration: Mucosal breach extending to or through muscularis mucosae; 98% in duodenum (first portion). More frequent in alcoholic cirrhosis, COPD, chronic renal failure, hyperparathyroidism (hypercalcemia increases gastrin). Pathogenesis: Imbalance between mucosal defense (mucus, bicarbonate, mucosal blood flow, apical transport, epithelial regeneration, prostaglandins) vs. aggressive forces (gastric acidity, H. pylori). H. pylori in 100% of duodenal ulcers and 70% gastric ulcers; signs of H.pylori pathogenesis include urease secretion, proteases, phospholipases, neutrophil production, and thrombotic occlusion. Grossly: Rounded, sharply punched-out crater (2-4 cm), in duodenum (anterior/posterior walls), lesser curvature of stomach; margins punched out without significant edge elevations. Histologically: 4 zones- base/margins, active inflammatory cells (mostly neutrophils), granulation tissue, fibrous scar. -Acute ulceration (severe stress): severe trauma, burns (Curling's), CNS injury (Cushing's), chronic NSAID/corticosteroid use. -Gastric carcinomas: 90-95% carcinomas, 4% lymphomas, 3% carcinoids, 2% GISTs. Two types: Intestinal (on intestinal metaplasia, M:F ratio 2:1), Diffuse (in younger patients, M:F ratio 1:1). Intestinal type pathogenesis: diet (nitrites, smoked food, pickles, excess salt, decreased fresh vegetables), H. pylori infection, pernicious anemia, altered anatomy (subtotal gastrectomy). Diffuse type pathogenesis: unknown. Pylorus & antrum (50-60%), cardia (25%), body & fundus (15-25%), lesser curvature (40%), greater curvature (12%). Macroscopically: Exophytic, flat/depressed, excavated, linitis plastica (diffuse thickening/permeation of gastric wall).

    • Small and Large Intestines:

      • Meckel's diverticulum: Failure of omphalo-mesenteric duct involution; blind-ended tubular protrusion; partial intestine layers.
      • Hirschsprung's disease: Dilated colon (>6-7 cm); functional obstruction due to absent Meissner's/Auerbach's plexuses; male/female ratio 4:1;
      • Acquired megacolon: Chagas disease, organic obstruction, toxic megacolon (UC/CD), functional obstruction.
      • Ischemic bowel disease: Arterial thrombosis (severe atherosclerosis, systemic vasculitis), embolism, venous thrombosis (oral contraceptives, antithrombin III deficiency), non-occlusive ischemia (HF, shock), radiation, volvulus, hernias. Three histological types: Transmural, mural, mucosal.
      • Angiodysplasia: Tortuous dilation of submucosal/mucosal blood vessels; cecum/right colon; after 6th decade; 20% lower intestinal bleeding.
      • Diarrheal diseases: Secretory, osmotic, exudative (infectious, IBD), malabsorption, motility disorders.
      • Malabsorption syndromes: Defective intraluminal digestion, terminal digestion, transepithelial transport; causes include pancreatic insufficiency, Zollinger-Ellison syndrome, ileal dysfunction/resection, biliary obstruction/hepatic dysfunction, lactase deficiency, bacterial overgrowth, abetalipoproteinemia, celiac disease, short gut syndrome, Crohn's disease, and lymphatic obstruction.
      • Celiac disease (gluten-sensitive enteropathy): Sensitivity to gluten in wheat, oats, barley, rye; gliadin proteins; flattened mucosal villi.
      • Idiopathic inflammatory bowel diseases (Crohn's disease, ulcerative colitis): Idiopathic; Genetic predisposition; abnormal intestinal structure; infectious causes; abnormal immune reactivity.
      • Crohn's disease: Granulomatous; affects any part of the GI tract; transmural involvement; neutrophilic infiltration; crypt abscess; often skip lesions; can be associated with iritis, uveitis, etc.; small intestine involvement (40%), small/colon (30%), colon alone (30%).
      • Ulcerative colitis: Nongranulomatous ulcero-inflammatory affecting colon; limited to mucosa/submucosa; starts in rectum, extends proximally; associated with other issues; common in western countries. Transmural involvement (diffuse mononuclear infiltrate, crypt abscess); associated with architectural disarray and fibrosis.
      • Familial polyposis syndrome: Autosomal dominant; development of 500-2500 colonic adenomas (tubular); risk of colon cancer is high; diagnosed with 100+ detected polyps.
      • Colorectal carcinomas: 98% adenocarcinomas; arise on adenomatous polyps; peak incidence 60-70 yrs; M:F ratio (20% more males); associated with high-refined carbohydrates, low-fiber diets, etc. (CECUM/ASCENDING COLON, RECTUM, DESCENDING/SIGMOID, SCATTERED); 1-3% occur in FAP or IBD patients.
      • Anal cancers: Squamous cell carcinomas.
      • Carcinoid tumors: Neuroendocrine tumors; from various GI sites; tendency to be aggressive correlates with site, depth & size.

    Blood Vessels

    • Endothelial cell function: Permeability barrier maintenance, anticoagulation/antithrombosis/fibrinolysis regulation (prostacyclin, thrombomodulin, heparin-like molecules, plasminogen activator), prothrombotic molecule elaboration (von Willebrand factor, tissue factor, plasminogen activator inhibitor), ECM production, blood flow modulation, inflammation and immunity regulation, cell growth regulation, LDL oxidation. Activated by cytokines, bacterial products, hemodynamic stresses, lipids, diabetes, viruses, complements, & hypoxia.
    • Vascular smooth muscle cells: Vasoconstriction/dilation, synthesize collagen, elastin, proteoglycans; elaborate growth factors/cytokines; migrate/proliferate following injury. Vascular structure/function tightly regulated in basal & activated states; physiologic/pathophysiologic stimuli can induce activation/dysfunction.
    • Atherosclerosis: Intimal lesions (atheromas); cause of ischemic heart disease; American Heart Association classifies into six types; caused by vessel wall injury/inflammation; can result in stable vs vulnerable plaques. Fatty streaks are earliest lesions; composed of subendothelial lipid-filled foam cells. Complications include rupture, ulceration, hemorrhage, thrombosis, aneurysm. Risk factors: Aging, male gender, family history, genetics, hyperlipidemia, hypertension, smoking, diabetes, obesity, inactivity, stress, postmenopausal estrogen deficiency, high carbohydrate intake, alcohol. Pathogenesis: endothelial injury, lipoprotein accumulation, lipoprotein oxidation, monocyte migration, platelet adhesion, smooth muscle cell migration/proliferation, lipid accumulation.
    • Hypertension: Common disorder affecting 25% of the population, major risk factor for atherosclerosis, heart failure, renal failure. Can be essential (95%) or secondary. Pathogenesis is complex, multifactorial. Types include Essential & Secondary. Secondary includes renal, endocrine (e.g., Cushing syndrome, hyperaldosteronism, pheochromocytoma), pregnancy-induced, cardiovascular, neurologic, sleep apnea. Kidneys regulate blood pressure via renin-angiotensin system, prostaglandins/NO, sodium conservation.
    • Vasculitis: Inflammation of vessel walls; often systemic manifestations & organ dysfunction; can be infectious or immune-mediated (immune complex deposition, ANCA/anti-endothelial cell antibodies), specific vessel types.
      • Variants: Giant cell arteritis, Takayasu's arteritis, polyarteritis nodosa, Kawasaki disease, microscopic polyangiitis, Wegener's granulomatosis, thromboangiitis obliterans.
    • Vascular tumors: Typically benign (e.g., hemangiomas) or highly malignant (e.g., angiosarcoma). Vascular ectasias are not tumors but dilations.

    Other Cardiovascular Diseases

    • Congenital cardiac diseases: Ventricular septal defect (VSD), atrial septal defect (ASD), pulmonary stenosis, patent ductus arteriosus (PDA), tetralogy of Fallot (TOF), coarctation of aorta, atrioventricular septal defect (AVSD), aortic stenosis, transposition of great arteries (TGA), truncus arteriosus (TA), total anomalous pulmonary venous connection (TAPVC), tricuspid atresia. Proportions for each disease listed in percentage.
    • Ischemic Heart Disease (IHD): Diminished coronary perfusion relative to myocardial demand; fixed atherosclerotic narrowing, intraluminal thrombosis, platelet aggregation, vasospasm. Obstruction leads to exertion symptoms, and 90% leads to rest symptoms (angina); acute plaque change can cause myocardial infarction (MI); Acute plaque changes include rupture/fissuring, erosion/ulceration, hemorrhage. Morphological effects vary based on time from initial injury.
      • Consequences of MI: Contractile dysfunction; arrhythmias; myocardial rupture; pericarditis; infarct extension; infarct expansion; mural thrombus; ventricular aneurysm; papillary muscle dysfunction; progressive late heart failure.
    • Infective Endocarditis (IE): Heart valve or mural endocardium colonization; destruction of tissues often; friable vegetations (thrombotic debris & organisms); classified as acute or subacute; can be caused by various microbes (Streptococcus viridans, Staphylococcus aureus, others).
    • Rheumatic Heart Disease (RHD): Immunologically mediated multisystem inflammatory disease, few weeks after group A streptococcal pharyngitis; acute rheumatic carditis can progress; focal inflammatory lesions in tissues (Aschoff bodies, composed of swollen eosinophilic collagen surrounded by lymphocytes, plasma cells, plump macrophages (Anitschkow cells)); can affect all heart layers; chronic damage leads to valvular thickening and retraction.
      • Cardinal anatomic changes of the mitral/tricuspid valves: leaflet thickening, commissural fusion, and shortening of tendinous cords.
    • Varicose veins: Deep/superficial vein dilatation; role of valves, muscle pump, blood volume/position. Symptoms include cosmetic concerns, pain, inflammation, leg ulcer, and rupture. Diagnosis: inspection, Doppler ultrasound, and duplex ultrasound. Etiology is related to congenital weakness/absence of valves; Genetic, gender, age, ethnic, body mass index, family history, lifestyle, and Pregnancy impact. Deep vein incompetency (retrograde flow) may have complications.
    • Aneurysm & Dissections: Aneurysm is weakened/destroyed arterial wall dilation or balloon-like bulge (Congenital/acquired dilation involving entire wall). Complications: rupture/thrombosis/embolization. Dissections are blood entering vessel wall separating layers leading complications. Common location: Thoracic & abdominal aorta; Cerebral; Peripheral. Types: (Aortic (abdominal/thoracic), Cerebral, Peripheral).
    • Heart failure: Inability to meet metabolic needs; systolic/diastolic dysfunction; compensatory mechanisms (Frank-Starling mechanism, ventricular remodeling, neurohormonal systems) lead to a vicious cycle; common etiologies include ischemic heart disease, hypertension, diabetes. Different types of LV failure, RV failure, sequels, and pathophysiology are outlined.

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    Description

    Test your knowledge on various diseases of the gastrointestinal tract, focusing on the oral cavity. This quiz covers conditions like aphthous ulcers, herpes simplex virus, oral candidiasis, and oral cancers. Learn about their causes, risk factors, and implications for health.

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